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2020 Borough of Gettysburg

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U.S.A. forms for Borough of Gettysburg

BROWSE BOROUGH OF GETTYSBURG (PA) FORMS

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Borough of Gettysburg
APPLICATION FOR REGULATED RENTAL UNIT OCCUPANCY LICENSE
ANNUAL LICENSE FEE- $36.00 per Unit
Required by Section 4-300 of the Gettysburg Borough Code of Ordinances
Revised January 2020
Address of Unit to be Licensed: ______________________________________________________________
One (1) rental unit per application
Description of Unit:
[ ] Single-Family House [ ] Half of Double House/ Duplex [ ] Apartment Unit
[ ] Dormitory [ ] Fraternity House [ ] Sorority House
[ ] Other __________________________________________________________________________________
Number of Occupants: ______ Date Occupant(s) Assumed Residency: _____________________,________
Month Day Year
List names and telephone numbers of each occupant on reverse page.
Is off-street parking provided for the tenant(s) of this rental unit? [ ] Yes [ ] No
If yes, where is it located? ___________________________________________________________________
Number of spaces: ________ Tenants eligible for Residential Parking Permit (RPP)? [ ] Yes [ ] No
To be filled out by office personnel only
License No.
Date Issued
Last Inspection
Next Inspection
No. Complaints
No. Units
Fees Paid
Occupants
Name of Property Owner_______________________________________________________________
Address____________________________________ Telephone (____) _____ - _________
____________________________________ Alt. Phone (____) _____ - _________
____________________________________ Email_______________________________
§4-302.2 If the property owner is not a full-time resident of the Borough of Gettysburg and does not reside within Adams
County, Pennsylvania, the owner shall designate a manager who shall reside within 40 miles of the rental unit.
Name of Designated Local Property Manager______________________________________________
Address ____________________________________ Telephone (_____) ______ - _________
____________________________________ Alt. Phone (_____) ______ - _________
____________________________________ Email________________________________
§4-302.2 If the owner is a partnership or a corporation, the names and addresses of all partners or officers are required.
Please print names, addresses and phone numbers of all partners or officers of the partnership or corporation on a separate
sheet of paper and attach it to this application. If no partners (in the case of a partnership) or no corporate officers (in the
case of a corporation) are residents of Adams County, Pennsylvania, a manager who resides or maintains offices within 40
miles of the rental unit must be designated.
§4-304F Names & Telephone Numbers of Each Occupant in Rental Unit
The names and telephone numbers of all occupants ages 16 and over must be provided on this application. Children under
age 16 are not required to be named, but must be designated as “Child, age___”. If one particular tenant is in charge of the
residential unit he/she should be listed first.
NOTE: YOU MUST SUBMIT AN UPDATE WITHIN 15 DAYS OF ANY CHANGES IN TENANTS.
No additional license fee required for tenancy changes.
Information is required.
OCCUPANT’S NAME
TELEPHONE NUMBER
UNIT
I have read, understand, and agree to comply with all requirements of the Gettysburg Borough Residential Rental
Occupancy Ordinance, fully understanding that failure to comply may result in disciplinary action including, but
not limited to revocation/denial of my annual RRUO license and/or citation.
_______________________________________ __________________________________________
Submitted By: Signature of Property Owner Received By: Signature of Borough Representative
_______________________________________ __________________________________________
Printed Name of Landlord/Property Owner Printed Name of Borough Representative
_______________________________________ __________________________________________
Title (if applicable) Title
_______________________________________ __________________________________________
Date Date
Regulated Rental Unit Occupancy (RRUO) Application – Revised January 2020
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2020 Borough of Gettysburg

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Completed 12 July 2020

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